umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Hörnsten, Åsa
Alternative names
Publications (10 of 50) Show all publications
Olsson, K., Näslund, U., Nilsson, J. & Hörnsten, Å. (2018). Patients' experiences of the transcatheter aortic valve implantation trajectory: A grounded theory study. Nursing Open, 5(2), 149-157
Open this publication in new window or tab >>Patients' experiences of the transcatheter aortic valve implantation trajectory: A grounded theory study
2018 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 2, p. 149-157Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to explore how patients experienced the recovery process from transcatheter aortic valve implantation. Design: A qualitative approach where in-depth interviews were used. Method: Eleven men and eight women undergoing transcatheter aortic valve implantation were individually interviewed 6 months after transcatheter aortic valve implantation. Grounded theory was used for the analysis. Results: The analysis generated the core concept "A journey of balancing between life-struggle and hope" connected to descriptive, bipolar categories. Before transcatheter aortic valve implantation patients not only felt threatened but also experienced hope. The rehabilitation phase was described as demanding or surprisingly simple. At the 6 months follow-up patients were pleased to return to life, however, still struggling with limitations. To feel hope is essential for transcatheter aortic valve implantation patients' well-being, both before and during the recovery process. It is important that healthcare professionals not only support hopeful thinking but also take time to discuss and prepare patients, talk about concerns and build confidence. Individual plans for rehabilitation should be designed.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
aortic stenosis, coping, hope, qualitative study, recovery, supportive nursing, transcatheter aortic valve implantation
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-148639 (URN)10.1002/nop2.124 (DOI)000428455600006 ()29599990 (PubMedID)
Available from: 2018-06-25 Created: 2018-06-25 Last updated: 2018-06-25Bibliographically approved
Ulrika, Ö., Isaksson, U., Jutterström, L., Orre, C.-J. & Hörnsten, Å. (2018). Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support. JMIR Diabetes, 3(1), Article ID e7.
Open this publication in new window or tab >>Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support
Show others...
2018 (English)In: JMIR Diabetes, ISSN 2371-4379, Vol. 3, no 1, article id e7Article in journal (Refereed) Published
Abstract [en]

Background: Digital health services are increasing rapidly worldwide. Strategies to involve patients in self-monitoring of type 2 diabetes (T2D) on a daily basis is of crucial importance, and there is a need to optimize the delivery of care such as self-management support. Digitalized solutions have the potential to modify and personalize the way in which people use primary health services, both by increasing access to information and providing other forms of support at a distance. It is a challenge to integrate core values of person-centered care into digitalized health care services.

Objective: The objective of this study was to describe perceptions of using electronic health (eHealth) services and related technologies for self-management support among people with T2D treated in Swedish primary health care.

Methods: This is a qualitative study based on interviews analyzed using qualitative content analysis conducted among people diagnosed with T2D.

Results: Findings suggest that the participants had mixed feelings regarding the use of digital health services for self-management support. They experienced potentials such as increased involvement, empowerment, and security, as well as concerns such as ambivalence and uncertainty.

Conclusions: Digital health services for self-management are easily accessible and have the potential to reach a wide population. However, targeted training to increase digital skills is required, and personalized devices must be adapted and become more person-centered to improve patients’ involvement in their own care.

Place, publisher, year, edition, pages
JMIR Publications, 2018
Keywords
eHealth, internet, type 2 diabetes, self-management, primary health care, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-145997 (URN)10.2196/diabetes.9059 (DOI)30291075 (PubMedID)2-s2.0-85047781902 (Scopus ID)
Available from: 2018-03-26 Created: 2018-03-26 Last updated: 2018-11-22Bibliographically approved
Ulrika, Ö., Orre, C.-J., Isaksson, U., Schimmer, R., Larsson, H. & Hörnsten, Å. (2018). Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management. Scandinavian Journal of Caring Sciences, 32(2), 961-970
Open this publication in new window or tab >>Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management
Show others...
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 961-970Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self-management for people with chronic conditions, it is important to highlight nurses' experiences. This study is part of a larger project aimed at implementing person-centred interactive self-management support (iSMS) in primary health care.

AIM: The aim of this study was to describe Swedish primary healthcare nurses' perceptions of using digital eHealth systems and services to support patient self-management.

METHODS: Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis.

RESULTS: Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes.

CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE: The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self-management support as well as giving the primary healthcare nurses adequate resources to support patients' self-management while still maintaining the values associated with person-centred care.

Keywords
chronic conditions, eHealth, nurses, primary health care, self-management, technology, type 2 diabetes
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-145996 (URN)10.1111/scs.12534 (DOI)000436254800053 ()28960451 (PubMedID)
Available from: 2018-03-26 Created: 2018-03-26 Last updated: 2018-10-19Bibliographically approved
Andertun, S., Hörnsten, Å. & Hajdarevic, S. (2017). Ebola virus disease: caring for patients in Sierra Leone - a qualitative study. Journal of Advanced Nursing, 73(3), 643-652
Open this publication in new window or tab >>Ebola virus disease: caring for patients in Sierra Leone - a qualitative study
2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 3, p. 643-652Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to describe Norwegian healthcare staffs' experiences of participating in care of patients with Ebola virus disease in Sierra Leone.

BACKGROUND: Ebola is one of the most feared viruses known. Ebola virus disease is highly contagious with high mortality. The few qualitative studies made on experiences among healthcare professionals have highlighted problems as lack of protective resources, insufficient personnel and risk of societal stigmatization.

DESIGN: Descriptive study with qualitative approach.

METHOD: Individual narrative and focus group interviews were obtained during 2015 with eight nurses and one physician who had worked in Ebola care in Sierra Leone. The interviews were analysed using qualitative content analysis.

RESULT: The analysis resulted in the two themes: 'Experiencing security by learning to manage risks'; and 'Developing courage and growth by facing personal fears'. Subthemes were: 'Relying on safeguard actions', 'Managing risk of contagion', 'Developing strategies for care despite risks', 'Constantly reminded of death', 'Successively defeating fears' and last, 'Increasing motivation through meaningfulness'. The participants described the reliance on training, organized effort, strict guidelines and equipment. They were respectful of the risk of transmission, made risk assessments, took responsibility, handled risky situations and were reminded of suffering and death.

CONCLUSION: Despite challenges, the hazardous work with Ebola virus disease patients was experienced as meaningful which was an important motivator. Safe care was central in working with Ebola patients, but the care relation was challenged.

Keywords
Ebola, Sierra Leone, care relation, experiences, healthcare professionals, nursing, qualitative design, risk, safety
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-127092 (URN)10.1111/jan.13167 (DOI)000399292400011 ()27747916 (PubMedID)
Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2018-06-09Bibliographically approved
Oftedal, B., Kolltveit, B.-C. H., Zoffmann, V., Hörnsten, Å. & Graue, M. (2017). Learning to practise the Guided Self-Determination approach in type 2 diabetes in primary care: A qualitative pilot study. Nursing Open, 4(3), 134-142
Open this publication in new window or tab >>Learning to practise the Guided Self-Determination approach in type 2 diabetes in primary care: A qualitative pilot study
Show others...
2017 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 3, p. 134-142Article in journal (Refereed) Published
Abstract [en]

Aim: To describe how diabetes nurses in primary care experience the process of learning to practise the person-centred counselling approach Guided Self-Determination among adults with type 2 diabetes. Design: A descriptive qualitative design. Method: Data were collected in 2014-2015 by means of individual interviews with four diabetes nurses at two points in time. The data were analysed using qualitative content analysis. Results: Three themes that reflect nurses' processes in learning to use the Guided Self-Determination approach were identified: (1) from an unfamiliar interaction to cracking the code; (2) from an unspecific approach to a structured, reflective, but demanding approach; and (3) from a nurse-centred to a patient-centred approach. The overall findings indicate that the process of learning to practise Guided Self-Determination increased the nurses' counselling competence. Moreover, the nurses perceived the approach to be generally helpful, as it stimulated reflections about diabetes management and about their own counselling practices.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-138547 (URN)10.1002/nop2.76 (DOI)000405085600003 ()28694977 (PubMedID)
Available from: 2017-09-14 Created: 2017-09-14 Last updated: 2018-06-09Bibliographically approved
Olsson, K., Nilsson, J., Hörnsten, Å. & Näslund, U. (2017). Patients’ self-reported function, symptoms and health-related quality of life before and 6 months after transcatheter aortic valve implantation and surgical aortic valve replacement. European Journal of Cardiovascular Nursing, 16(3), 213-221
Open this publication in new window or tab >>Patients’ self-reported function, symptoms and health-related quality of life before and 6 months after transcatheter aortic valve implantation and surgical aortic valve replacement
2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 3, p. 213-221Article in journal (Refereed) Published
Abstract [en]

Background: Aortic stenosis is the most common valve disease in western countries and has poor prognosis without treatment. Surgical aortic valve replacement (SAVR) is the gold standard, and transcatheter aortic valve implantation (TAVI) is a new method that is used in high-risk patients who are denied surgery. The purpose of treatment is not only to save life, but also to reduce symptoms and increase health-related quality of life (HRQoL).

Objective: The aim of this study was to describe patients’ self-reported outcomes in terms of physical function, symptoms, dependence, HRQoL, and cognitive function after TAVI and SAVR.

Methods: All patients treated with TAVI during 1 year (n = 24) and age-matched patients treated with SAVR (n = 24) were included. Data were collected on the day before and at 6 months after treatment using structural questionnaires.

Results: Self-rated function was low before treatment and increased at follow-up. A quarter of all patients reported syncope at baseline, and none reported this at follow-up. Breathlessness was reported by all patients to be the most limiting cardiac symptom, but the TAVI patients reported more severe symptoms. At 6 months’ follow-up, symptoms were reduced, but breathlessness and fatigue were still common, especially in the TAVI group. HRQoL, which was very low in the TAVI group at baseline, increased in all dimensions except social function.

Conclusion: We found no change in cognitive function or dependence at follow-up. There was no difference in the size of improvement between groups. The results could be helpful when informing future patients in order to give them realistic expectations.

Keywords
Aortic valve stenosis, transcatheter aortic valve implantation, surgical aortic valve replacement, self-rated outcome
National Category
Nursing
Research subject
Medicine, cardiovascular disease
Identifiers
urn:nbn:se:umu:diva-127870 (URN)10.1177/1474515116650342 (DOI)000398178900005 ()27169460 (PubMedID)2-s2.0-85012079897 (Scopus ID)
Available from: 2016-11-21 Created: 2016-11-20 Last updated: 2018-06-09Bibliographically approved
Olsson, K., Näslund, U., Nilsson, J. & Hörnsten, Å. (2016). Experiences of and Coping With Severe Aortic Stenosis Among Patients Waiting for Transcatheter Aortic Valve Implantation. Journal of Cardiovascular Nursing, 31(3), 255-261
Open this publication in new window or tab >>Experiences of and Coping With Severe Aortic Stenosis Among Patients Waiting for Transcatheter Aortic Valve Implantation
2016 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 31, no 3, p. 255-261Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Aortic stenosis (AS) is the most common valve disease in Western countries. Transcatheter aortic valve implantation (TAVI) has made it possible to treat patients with higher surgical risks. These patients are informed about their poor prognosis with only months or a few years to live without treatment. Because of their severe symptoms, limitations, and suffering, patients awaiting TAVI need special attention.

OBJECTIVE: The aim of this study is to describe patients' experiences of coping with severe AS and of waiting for TAVI.

METHODS: Swedish participants (n = 24; 9 women, 15 men) with a mean (SD) age of 80 (7.4) years who had been offered TAVI all agreed to participate in a presurgical interview. The interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis.

RESULTS: The participants' experiences of coping with AS and awaiting TAVI were described by the main theme "living on the edge, but trying to stay in control," which comprised 3 categories: "trying to cope with physical symptoms and anxiety," "trying to preserve self and self-esteem despite life-threatening illness," and "trying to process the decision to undergo TAVI."

CONCLUSIONS: Patients with AS and awaiting TAVI must cope with increasing symptoms and limitations in their social lives but still wish to be seen as the people they always have been. These patients may need extra support from healthcare personnel to process their experiences, which could help them to attach personal meaning to clinical information about the condition and its treatment that they could include in their decision about whether to undergo TAVI. Listening to patients' stories could help nurses and physicians to ensure that disease and treatment are meaningfully understood by the patient.

Keywords
aortic stenosis, coping, experiences, symptoms, transcatheter aortic valve implantation
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-120742 (URN)10.1097/JCN.0000000000000231 (DOI)000375047600011 ()25658189 (PubMedID)
Available from: 2016-05-20 Created: 2016-05-19 Last updated: 2018-06-07Bibliographically approved
Jutterström, L., Hörnsten, Å., Sandström, H., Stenlund, H. & Isaksson, U. (2016). Nurse-led patient-centered self-management support improves HbA1c in patients with type 2 diabetes: A randomized study. Patient Education and Counseling, 99(11), 1821-1829
Open this publication in new window or tab >>Nurse-led patient-centered self-management support improves HbA1c in patients with type 2 diabetes: A randomized study
Show others...
2016 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 99, no 11, p. 1821-1829Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to evaluate the effect of a patient-centered self-management support, in type 2 diabetes (T2D) with regard to metabolic changes.

METHODS: 182 patients were randomized into group intervention (GI), individual intervention (II) or internal controls (IC). An external control (EC) group was recruited from another county council. The intervention consisted of six sessions that featured themes, which regarded different views of their illness experiences. Data were collected in 2010 and 2011.

RESULTS: HbA1c was significantly decreased at 12-month follow-up with 5mmol/mol in the GI and 4mmol/mol in the II. In the IC group, the HbA1c was close to baseline. The EC group had increased HbA1c, though not significantly. When the HbA1c difference at baseline was adjusted, there was a significant difference between intervention groups and the EC-group.

CONCLUSION: Patient-centered self-management support, led by nurses, can lower HbA1c among patients with type 2 diabetes.

PRACTICE IMPLICATIONS: It is possible to train diabetes specialist nurses in clinical patient-centered care, and simultaneously influence patients' metabolic balance positively.

National Category
Endocrinology and Diabetes Nursing
Identifiers
urn:nbn:se:umu:diva-127491 (URN)10.1016/j.pec.2016.06.016 (DOI)000391222100011 ()27372525 (PubMedID)
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-06-09Bibliographically approved
Olsson, K., Näslund, U., Nilsson, J. & Hörnsten, Å. (2016). Patients' Decision Making About Undergoing Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis. Journal of Cardiovascular Nursing, 31(6), 523-528
Open this publication in new window or tab >>Patients' Decision Making About Undergoing Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis
2016 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 31, no 6, p. 523-528Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Aortic stenosis is the most common valve disease in Western countries, and its prevalence is increasing because of the aging population. Some patients, denied surgery because of high risk, can be offered transcatheter aortic valve implantation (TAVI). These patients are old and have comorbidities, and it is not always easy for them to make the decision about accepting TAVI.

OBJECTIVE: The aim of this study was to describe the decision-making process about undergoing TAVI treatment among people with severe aortic stenosis who are denied surgery.

METHODS: The Swedish participants (n = 24) with a mean age of 80 years who had been offered TAVI all agreed to participate in a presurgical interview. The interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis.

RESULTS: Three patterns in the decision-making process about TAVI treatment-ambivalent, obedient, and reconciled-were identified. The ambivalent patient is unsure of the value of treatment and aware of the risks; the obedient patient is unsure of the value of one's own decision and wants to leave the decision to others; the reconciled patient has reached a point where there is no choice anymore and is always sure that the decision to undergo TAVI is right.

CONCLUSIONS: People with aortic stenosis who are offered TAVI need to discuss the risks and benefits in order to participate in decision making about the treatment. They have different patterns in decision making and would benefit from healthcare professionals being observant of them to support them in this process in a manner consistent with their values.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2016
Keywords
aortic stenosis, decision making, transcatheter aortic valve implantation
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-120771 (URN)10.1097/JCN.0000000000000282 (DOI)000386979500019 ()26110543 (PubMedID)
Available from: 2016-05-20 Created: 2016-05-20 Last updated: 2018-06-07Bibliographically approved
Zoffmann, V., Hörnsten, Å., Storbaekken, S., Graue, M., Rasmussen, B., Wahl, A. & Kirkevold, M. (2016). Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination. Patient Education and Counseling, 99(3), 400-407
Open this publication in new window or tab >>Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination
Show others...
2016 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 99, no 3, p. 400-407Article in journal (Refereed) Published
Abstract [en]

Objective: Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. Methods: Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. Results: Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. Conclusion: Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. Practice Implications: Professionals must critically consider the context in their choice of approach. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Empowerment, Person-centred care, Chronic illness, Translational research, Self-management, tivational interviewing, Life skills, Illness integration, Guided self-determination, Comparative analysis
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-119072 (URN)10.1016/j.pec.2015.10.015 (DOI)000371989700012 ()26547303 (PubMedID)
Available from: 2016-04-20 Created: 2016-04-11 Last updated: 2018-06-07Bibliographically approved
Organisations

Search in DiVA

Show all publications